Who's affected by Iowa's new Medicaid system?

With a new Medicaid delivery system launching today in Iowa, here are some frequently asked questions for enrollees, caregivers and family members:

1. Which Iowa Medicaid patients will be affected?

More than 90 percent of Iowans receiving Medicaid services will receive services through managed-care organizations under the new system. They include most in the Iowa Health and Wellness Plan (Iowa's version of Medicaid expansion), low-income families and children, people receiving long-term care and those who receive waivers for home- and community-based services, among others.

Among the few who will remain in Medicaid's fee-for-service delivery system are those who qualify for services through the Health Insurance Premium Payment Program, Medicare Savings Program or as a Qualified or Specified Low-Income Medicare Beneficiary.

2: Will services change or be cut?

MCOs are required to cover all services currently covered by Iowa Medicaid, at a minimum, and Medicaid enrollees' benefits will remain the same, according to the state Department of Human Services.

Confused by how the new Medicaid system works?

We're here to help. Click the image above to check out an interactive explanation of Iowa's new Medicaid managed care system.

Covered services include but are not limited to inpatient and outpatient services, behavioral care, home- and community-based services, facility-based care and transportation.

3. When will member cards be delivered?

If any have not already received their new member identification cards, Medicaid patients should watch their mail, the state DHS said, as cards were to be delivered by today. Those cards are delivered by the enrollee's MCO.

4. Can patients keep their provider?

Yes, but with a caveat. To be fully reimbursed by Medicaid, providers must contract with at least one of the MCOs. If a provider is not contracted with an MCO, that provider will not receive full reimbursement and will decide on its own whether to see Medicaid patients.

5. Can enrollees keep their case manager?

They can for the first six months, at which time the MCOs will assign case managers. The MCOs will work with patients on getting an appropriate case manager, according to the state DHS.

6. Can patients switch MCOs?

Members can change MCOs for any reason until June 16. After June 16, members may change MCOs for 'good cause' reasons, for example a provider is not in the MCO's network or there has been a change in the member's eligibility.

7. Whom should patients contact?

There are several options for Medicaid recipients who have questions or concerns. Enrollees can start with the state Department of Human Services at 800-338-8366.

The state department also has extensive information and materials at its website dedicated to the Medicaid transition, dhs.iowa.gov/iahealthlink.

Iowans receiving Medicaid services for long-term care or waiver services or receive care in assisted-living facilities may take concerns to the state Medicaid managed-care ombudsman office by calling 1-866-236-1430 or emailing ManagedCareOmbudsman@iowa.gov.